丙种球蛋白对单纯疱疹病毒性脑炎患儿BDNF及神经相关蛋白表达的影响

Effect of gamma globulin on the expressions of BDNF and neural related proteins in children with herpes simplex encephalitis

目的探究丙种球蛋白对单纯疱疹病毒性脑炎(herpes simplex encephalitis,HSE)患儿神经相关蛋白表达及脑源性神经营养因子(BDNF)的影响。方法选取2019年9月—2021年10月南阳市第二人民医院收治的HSE患儿86例,按随机数字表分为两组,每组43例。两组均实施常规基础治疗,对照组给予更昔洛韦治疗,观察组在上述基础上加用丙种球蛋白治疗,均连续治疗5天,对比两组临床疗效、神经相关蛋白表达[髓鞘碱性蛋白(MBP)、β-内啡肽(β-EF)、神经元特异性烯醇化酶(NSE)]、BDNF水平及不良反应。结果观察组治疗总有效率为95.35%,高于对照组的79.07%,差异有统计学意义(P<0.05);治疗后,观察组神经相关蛋白指标低于对照组,BDNF水平高于对照组,差异有统计学意义(P<0.001);治疗后,对照组不良反应发生率为9.30%,观察组不良反应发生率为4.65%,两组比较差异无统计学意义(χ2=0.179,P=0.672)。结论丙种球蛋白在单纯疱疹病毒性脑炎患儿中有良好的治疗效果,能有效降低神经相关蛋白各项指标,提高患儿BDNF水平,无明显不良反应,安全可靠,值得进一步推广。

Objective To investigate the effect of gamma globulin on the expressions of neurorelated proteins and brain-derived neurotrophic factors(BDNF)in children with herpes simplex encephalitis(HSE).Methods 86 children with HSE admitted to the Second People's Hospital of Nanyang from September 2019 to October 2021 were selected.All children were randomly divided into two groups,with 43 cases in each group.Both groups were treated with routine basic treatment,then control group were treated with ganciclovir,and observation group were treated with gamma globulin on the above-mentioned basis.The two groups were treated for 5 consecutive days.The clinical efficacy and neural related protein expressions(myelin basic protein[MBP],β-endorphins[β-EF],neuron specific enolase[NSE]),BDNF levels and adverse reactions of the two groups were compared.Results The total effective rate of the observation group was 95.35%,which was higher than that(79.07%)of the control group(P<0.05).After treatment,the index of nerve related proteins in the observation group was lower than that in the control group,and the levels of BDNF were higher than those in the control group(P<0.001).After treatment,the incidence of adverse reactions in the control group was 9.30%,and that of the observation group was 4.65%,and difference was not statistically significant between the two groups(χ2=0.179,P=0.672).Conclusion Gamma globulin has a good therapeutic effect in children with herpes simplex encephalitis.It can effectively reduce various indexes of neural related proteins and improve the levels of BDNF in children without obvious adverse reactions,which is safe and reliable,and is worthy of further promotion.